State releases initial draft of COVID-19 mass vaccination plan

Governor Larry Hogan today announced the release of the State of Maryland’s initial draft of the COVID-19 mass vaccination plan, which was submitted to the Centers for Disease Control and Prevention (CDC) last week. The plan describes distribution in two phases, one for the most vulnerable and a second phase for the general public. Read the draft plan here.

“In anticipation of a COVID-19 vaccine, Maryland stands ready to order, distribute, and administer it effectively and rapidly as soon as a vaccine becomes available,” said Governor Hogan, ina statement. “The State of Maryland’s plan for this historic undertaking will immediately make the vaccine available to Marylanders at highest risk of developing complications from COVID-19 as well as our critical frontline health care workers and essential workers in public safety and education.”

Phase 1 will focus on priority groups to receive the vaccination. Those groups include first responders and health care workers, staff and residents of nursing homes and long-term care facilities, and essential workers.

Phase 2 will have wide-scale vaccine availability for the general population.

Vaccine supply is expected to rapidly increase once distribution begins, alleviating the need to limit vaccine administration.

Once Phase 1 vaccination targets have been met, the state will move on to distribution in Phase 2. Phase 1 metrics under consideration include the percent of the Phase 1 population vaccinated; percent and number of residents and staff at long-term care facilities vaccinated; determination of an equitable distribution of COVID-19 vaccine throughout the state for the Phase 1 population; percent and number of Phase 1 population pre-registered.

The MDH will require pre-registration of Phase 1 vaccine sites and registration of priority vaccine candidates at each site.  The plan indicates that most vaccines currently under study require two doses taken 21 to 28 days apart.

The determination to begin Phase 2 will be influenced by the availability of the vaccine, sufficient supply; and the achievement of targets for Phase 1.

Primary Components of Maryland’s Draft COVID-19 Vaccination Plan

Provider Recruitment and Enrollment. MDH is in the process of recruiting and enrolling health care providers, local health departments, employee occupational health providers, and pharmacists in Maryland’s Vaccine Program Immunization Information System (ImmuNet) to ensure that there will be sufficient vaccinators to meet local needs. ImmuNet is where providers register to order COVID-19 vaccines, track delivery of vaccines, report doses administered and determine when second doses are due.

Vaccine Allocation, Ordering, Distribution, and Inventory Management. Sites and priority vaccine candidates will be required to pre-register for the vaccination.  Vaccine orders will be placed in ImmuNet, which will then be uploaded to the CDC VTrckS vaccine ordering system for shipping directly to the hospital or work site.

Vaccine Storage and Handling. COVID-19 vaccine products are temperature sensitive and will need to be stored and handled correctly to ensure vaccine viability prior to administration to a patient. The CDC is currently developing storage and handling guidelines for COVID-19 vaccines.

Vaccine Safety Monitoring. With the rapid development and licensing of COVID-19 vaccines, vaccine safety monitoring is a high priority to establish and maintain confidence in the vaccine. CDC and the FDA continuously monitor the safety of vaccines. Three main systems are used to monitor the safety of vaccines: MDH participates in the Vaccine Adverse Event Reporting System (VAERS), Vaccine Safety Datalink (VSD), and Clinical Immunization Safety Assessment Project.

Vaccination Program Metrics. Monitoring of the COVID-19 vaccination program will be critical to the program’s success, and several online dashboards are currently under development. The weekly flu vaccination dashboard and the COVID-19 vaccination response dashboard will use data related to flu and COVID-19 vaccination that are collected from various sources. MDH will also have Maryland-specific dashboards based on information collected in ImmuNet.

Vaccination Second Dose Reminders. For most COVID-19 vaccines, two doses of vaccine will be required separated by >21 or >28 days. Second dose reminders will be provided to patients in several ways. Marylanders may choose to receive reminders through PrepMod, an online resource that will be used to schedule clinics, track equipment needs, and report vaccination activity. Alternatively, patients may be scheduled for second doses from the provider-based systems. Maryland also has a dedicated consumer vaccination portal, Maryland MyIR, which allows registered users to obtain their current vaccination records from ImmuNet, and can also be used to issue reminder messages if two doses are required.

Public Health Campaign. MDH will coordinate with trusted community partners, priority group representatives, and representatives of vulnerable populations, along with a marketing vendor, to execute a public health campaign focused on the safety and efficacy of a vaccine.